公共卫生研究摘要 (2025-09-17)
共收录 51 篇研究文章
1. Acute Effects of Caffeine and Taurine Co-Ingestion on Time to Exhaustion and Thermoregulatory Responses to Cycling in the Heat.
期刊: European journal of sport science 发表日期: 2025-Oct 链接: PubMed
摘要
Caffeine and taurine are commonly co-ingested pre-exercise but elicit different thermoregulatory responses; however, their combined effect on thermoregulation is unknown. Therefore, we evaluated the effects of oral caffeine and taurine co-ingestion on time to exhaustion (TTE) and thermoregulatory responses to cycling in the heat at the gas exchange threshold (GET). Ten healthy nonheat acclimated participants took part in a double-blind crossover study, completing a TTE in the heat (35°C; 40% relative humidity), cycling at a power output associated with the GET and 1 h after ingesting: caffeine (5 mg/kg) and taurine (50 mg/kg) combined or placebo. Pulmonary gas exchange, core and mean skin temperatures and whole-body sweat rate (WBSR) were recorded throughout. Heat production was determined using partitional calorimetry. There were no differences in TTE between conditions (p = 0.608); however, the rate of oxygen consumption (p = 0.017), minute ventilation (p = 0.029) and heat production (p = 0.019) were higher following the supplement. There were no differences between conditions for skin (p = 0.539) and core temperature (p = 0.699), mean skin blood flow (p = 0.119), respiratory exchange ratio (p = 0.546) and WBSR (p = 0.897). Pre-exercise co-ingestion of caffeine and taurine in the heat had no ergogenic effect despite increasing the ventilatory and metabolic demand. Collectively, these data indicate minimal effects on whole-body thermoregulation.
2. Life without sex: Large-scale study links sexlessness to physical, cognitive, and personality traits, socioecological factors, and DNA.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Sep-23 链接: PubMed
摘要
Romantic (typically sexual) relationships are important to personal, physical, mental, social, and economic well-being, and to human evolution. Yet little is known about factors contributing to long-term lack of intimate relationships. We investigated phenotypic and genetic correlates of never having had sex in ~400,000 UK residents aged 39 to 73 and ~13,500 Australian residents aged 18 to 89. The strongest associations revealed that sexless individuals were more educated, less likely to use alcohol and smoke, more nervous, lonelier, and unhappier. Sexlessness was more strongly associated with physical characteristics (e.g., upper body strength) in men than in women. Sexless men tended to live in regions with fewer women, and sexlessness was more prevalent in regions with more income inequality. Common genetic variants explained 17% (SE = 4%) and 14% (SE = 3%) of variation in sexlessness in men and women, with a genetic correlation between sexes of 0.56 (SE = 0.17). Polygenic scores predicted a range of related outcomes in the Australian dataset. Our findings uncover multifaceted correlates of human intimacy and raise important lines of enquiry in the evolutionary and social sciences.
3. Research Letter: Safety, Feasibility, Acceptability and Preliminary Findings From Veterans' Intervention Blending NeuRomodulation and YogA for Chronic PaiN Treatment: VIBRANT-MTBI and Chronic Pain Pilot.
期刊: The Journal of head trauma rehabilitation 发表日期: 2025-Sep-16 链接: PubMed
摘要
To examine the feasibility, acceptability, safety, and preliminary findings of a blended intermittent theta burst stimulation and LoveYourBrain (LYB) Yoga (iTBS + LYByoga) intervention for improving pain among Veterans with chronic mild traumatic brain injury and chronic musculoskeletal pain (mTBI + CP). Single VA hospital. Nineteen Veterans (68.4% men) with mTBI + CP enrolled. Fourteen Veterans met full eligibility criteria and initiated iTBS + LYByoga. Single group, open-label, mixed methods, pilot clinical trial of iTBS + LYByoga. Participants received iTBS to the motor cortex at 80% of the motor threshold immediately followed by group LYB Yoga once a week for 6 weeks. To assess feasibility, intervention completion rates were assessed post-treatment. To assess safety, adverse events and 17 safety indicators were collected at each intervention session. To assess acceptability, self-reported satisfaction ratings, and semi-structured qualitative interviews were assessed post-treatment. To assess preliminary outcomes, the Brief Pain Inventory (BPI) was completed pre- and post-treatment: pain severity and pain interference scores were computed. Nineteen Veterans enrolled and 14 initiated the intervention. Our sample had a 71.4% (10/14) completion rate for all 6 sessions. There were no serious adverse events. The most common side effect was headaches experienced by 3 Veterans. The self-report satisfaction ratings indicated that most Veterans (60%) rated the quality of the program “excellent.” Qualitative interview data support these feasibility and acceptability findings. Mean self-reported pain severity via the BPI significantly improved (P = .0026) between pre-treatment and post-treatment (Cohen’s d effect size = 1.3). Mean self-reported pain interference from the BPI did not change (P = .0609) between pre-treatment and post-treatment (Cohen’s d effect size = .7). Lack of serious adverse events suggests that the iTBS + LYByoga intervention is safe among veterans with mTBI + CP. The program’s feasibility and acceptability coupled with improvements in self-reported pain outcomes warrants further research in a larger, randomized control trial.
4. Documentation of menopause-related international classification of diseases codes in the electronic health record in midlife women with menopause symptoms.
期刊: Menopause (New York, N.Y.) 发表日期: 2025-Sep-16 链接: PubMed
摘要
To evaluate the documentation of menopause-related International Classification of Diseases-10 (ICD-10) codes in the electronic health record (EHR) among midlife women with moderate or greater menopause symptoms receiving primary care. This cross-sectional study from the Hormones and Experiences of Aging (HERA) cohort included women aged 45-60 years receiving primary care at one of 4 Mayo Clinic sites who completed a one-time survey between March 1, 2021 and June 30, 2021. The survey captured demographic data, menopause symptoms using the Menopause Rating Scale (MRS), health care utilization, and treatment. Women with an MRS score ≥12 were included. The primary outcome was documentation of a menopause-related ICD-10 code in the EHR in the 12 months before survey completion. Of 5,254 women with completed surveys, 2,414 (49%) had an MRS score ≥12 and were included. Among these, 1,519 (63%) reported seeking care for their menopause symptoms in the past 12 months, but only 345 (23%) had a menopause-related ICD-10 code. Women with an ICD-10 code had higher MRS scores (18 [IQR: 14-22] vs 17 [IQR: 14-20]; P = 0.002) and were more likely to use systemic hormone therapy (HT; 26% vs 9%; P < 0.001), and vaginal HT (20% vs 6%; P < 0.001). Menopause-related ICD-10 diagnosis codes were under-documented in women with significant menopause symptom burden. Those with a code were more likely to report menopause treatment. These findings highlight a critical gap between symptom burden and diagnosis coding in the EHR, underscoring the need to improve identification and management of menopause symptoms.
5. Association Between Hair Trace Element Content and Children's Growth and Development: Protocol for a Cross-Sectional Surveillance Study.
期刊: JMIR research protocols 发表日期: 2025-Sep-16 链接: PubMed
摘要
Western Kazakhstan, a major industrial region, faces environmental challenges from the release of toxic elements due to intensive industrial activities. The combined impact of anthropogenic factors, trace element deficiencies, and harsh climatic conditions contributes to the deterioration of child health and growth. This study aimed to investigate the elemental profile of the child population in the western region of Kazakhstan. A total of 2279 school-aged children (aged 5 to 18 years) who are permanent residents of the Aktobe, Mangystau, Atyrau, and West Kazakhstan regions will be included in the study using a cluster sampling method. The elemental composition of their hair will be analyzed using inductively coupled plasma mass spectrometry on an Agilent 8900 inductively coupled plasma mass spectrometer (Agilent Technologies). Children’s physical growth will be assessed according to the World Health Organization (2007) growth standards and characterized using the following z score values: body weight for age for children aged younger than 10 years, height for age, and BMI for age. The cutoff points of z score values make it possible to diagnose thinness, stunting, overweight, or obesity. Multiple linear regression analysis will be applied to assess the association between chemical element content in hair and z score measures of children’s physical growth, as well as associations with gender, age, sociodemographic factors, and residential status. Reference values for chemical element content in biological substrates of the western Kazakhstan population will be established using 95% coverage intervals with 95% CIs following International Union of Pure and Applied Chemistry recommendations. The chemical element content will be reflected in a web-based atlas. After recruitment of participants, data will be collected between September 2023 and March 2025. Data processing and analysis will be completed in September 2025. Publication of the results is expected in December 2025. An analysis will be conducted to determine the differences in the levels of elements in groups of boys and girls, urban and rural children, and groups of children of different ages. According to the results of multiple regression analysis, chemical elements influencing the indicators of the physical development of children will be identified. The identified associations between trace and macroelement content and children’s growth indicators will allow for the development of region-specific public health measures, such as nutritional supplements, environmental remediation, and policies aimed at reducing exposure to toxic elements. In addition, identifying differences between rural and urban populations could inform the development of targeted prevention strategies. The developed web-based atlas of trace and macroelement content will be necessary for further research on the prevalence, etiology, risk factors, and possible mechanisms of development of environmentally dependent, endemic diseases in the region. Reference values of trace and macroelement content will also be established. DERR1-10.2196/72207.
6. Identifying the Factors Associated With Spatial Clustering of Incident HIV Infection Cases in High-Prevalence Regions: Quantitative Geospatial Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Sep-16 链接: PubMed
摘要
Incident HIV infection is a critical indicator of an ongoing epidemic, particularly in high-burden regions such as Liangshan Yi Autonomous Prefecture in China, where HIV prevalence exceeds 1% in 4 key counties (Butuo, Zhaojue, Meigu, and Yuexi). Identifying spatial clusters and drivers of recent infections is essential for implementing targeted interventions. Despite advancements in geospatial analyses of HIV prevalence, studies identifying drivers of incident HIV clustering remain limited, especially in low-resource settings. This study aims to identify spatial clusters of recent HIV infections and investigate potential driving factors in 4 key counties of the Liangshan Yi Autonomous Prefecture to inform targeted intervention strategies. From November 2017 to June 2018, we identified 246 (4.42%) recent HIV infection cases from 5555 newly diagnosed cases through expanded testing of the whole population in 4 key counties of Liangshan Yi Autonomous Prefecture. Recent infection cases were confirmed using limiting antigen avidity enzyme immunoassays or documented seroconversion within 6 months. The spatial distribution of incident HIV infection cases was analyzed using kernel density. Potential drivers, including population density, HIV prevalence, elevation, nighttime light index, urban proximity, and antiretroviral therapy (ART) coverage, were analyzed. The spatial lag regression model was used to identify factors associated with clustering of recent infection cases. The Geodetector q-statistic was used to quantify nonlinear interactive effects among these factors. Significant spatial autocorrelation was observed in the distribution of recent HIV cases (Moran I=0.11; P<.01). Six spatial clusters were identified, and all were located near urban centers or major roads. Furthermore, 5 factors were identified by the spatial lag regression model as being significantly correlated with the clustering of recent HIV infection cases, including population density (β=0.59; P<.001), HIV prevalence (β=0.02; P<.001), distance to local urban area (β=-3.10; P=.01), SD of elevation (β=-0.15; P=.02), and ART coverage rate (β=183.80; P<.01). Geodetector analysis revealed strong interactive effects among these 5 factors, with population density and HIV prevalence exhibiting the largest interactive effect (q=0.69). This study reveals that besides HIV prevalence, urbanization-related factors (population density and proximity to urban area) and transportation accessibility drive incident HIV clustering in Liangshan Yi Autonomous Prefecture. Paradoxically, higher ART coverage was associated with increased transmission, suggesting the need for integrated prevention strategies beyond ART expansion. Furthermore, the township-level geospatial approach provides a valuable model for pinpointing transmission hot spots and tailoring interventions in high-burden regions globally.
7. Development of a Web-Based Intervention to Support Primary Health Care Professionals in Digital Health Measurement: User-Centered Participatory Approach.
期刊: JMIR formative research 发表日期: 2025-Sep-16 链接: PubMed
摘要
Digital health measurement offers opportunities to address several primary health care challenges, but health care professionals encounter significant implementation barriers. Therefore, resources need to be developed to facilitate the integration of digital health measurement into daily practice. We aim to identify the most appropriate format and content for an intervention to support primary health care professionals in adopting digital health measurement. In addition, we describe and reflect on the development process. We used a participatory action research approach as well as user-centered design principles. A total of 19 primary health care professionals from 4 disciplines-physical therapy, occupational therapy, speech and language therapy, and general practitioner practice assistance-participated in intervention development as end users. External experts were consulted to broaden perspectives. Data were collected across 3 iterative stages (concept, design, and testing and trials) between January 2022 and December 2023 during cocreative meetings, individual interviews, focus group discussions, usability testing, and prototype use in daily practice. Data were analyzed using content analysis and descriptive statistics. A web-based, stepwise intervention combining theoretical information, practical aids, examples, and experiences proved most suitable. Key features were concise content, intuitive and attractive graphic design, and flexible navigation and functionalities. Iterative improvements led to an increase in usability ratings from “okay” to “good to excellent.” Different health care disciplines benefit from similar support strategies; yet, this requires a careful balancing of intervention design and content. Combining participatory action research and user-centered design principles was useful to tailor the intervention to end users’ daily routines. The described development process offers a replicable framework for creating support strategies for digital health measurement in various health care settings.
8. Public Perspectives on Palliative and Hospice Care: Social Media Content Analysis Using Topic Modeling and Multiclass Sentiment Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Sep-16 链接: PubMed
摘要
Palliative care enhances dignity and quality of life for patients with serious illnesses by managing distressing symptoms and supporting families. However, inadequate awareness and misconceptions often hinder patients and their families from accessing these services. Understanding of public perspectives on palliative and hospice care can facilitate the development of targeted educational resources and awareness campaigns. As social media becomes an important source of health information, analyzing such publicly available web-based sources can yield valuable insights into perceptions of palliative and hospice care. This study analyzed public perspectives posted on a popular social media platform in South Korea to understand perceptions, challenges, needs, and sentiments related to palliative and hospice care. Data were collected from Naver Knowledge iN, a popular web-based public forum in South Korea, encompassing 34,501 texts posted between 2002 and 2024. After applying inclusion and exclusion criteria, 9072 relevant perspectives were analyzed. Contextualized topic modeling was used to identify themes, and the optimal model was selected based on coherence, diversity scores, and expert feedback. In addition, multiclass sentiment analysis using a fine-tuned Korean bidirectional encoder representations from transformers (KoBERT) model classified sentiments into 6 categories. The multiclass sentiment model’s performance was evaluated using accuracy, precision, recall, and F1-score. Social media discussions on palliative and hospice care have increased steadily over time. Topic modeling identified 9 themes, with “ethical and legal concerns” and “medical care in hospitals” peaking in recent years, suggesting growing public interest in these areas. “Emotional and psychological support” emerged as the predominant theme, reflecting a significant need for psychosocial assistance among patients and their families. Sentiment analysis revealed that “sadness,” “anxiety,” and “neutral” were common emotions across many topics. Notably, themes such as “emotional and psychological support,” “disease treatment outcomes and prognosis,” “medical care in hospitals,” “financial issues,” and “symptom management” were predominantly associated with “sadness,” while “administrative and volunteer services,” “ethical and legal concerns,” and “nutrition management” were more closely linked with “anxiety.” This study highlights public concerns about palliative and hospice care in South Korea, including ethical dilemmas, caregiving burden, and emotional distress. Findings underscore the need for communication strategies that address informational, emotional, and psychological needs. Culturally sensitive, interactive communication tools, such as artificial intelligence-powered chatbots and public education campaigns, may help dispel misconceptions and promote timely, informed decisions about palliative and hospice care.
9. Understanding Economic Decision-Making in Digital Therapeutics Development: Qualitative Approach.
期刊: Journal of medical Internet research 发表日期: 2025-Sep-16 链接: PubMed
摘要
Digital therapeutics (DTx) represent a transformative shift in health care delivery, offering software-driven, evidence-based therapeutic interventions. Despite their potential, adoption remains low across health care systems, partly due to insufficient economic evidence. Significant knowledge gaps persist regarding stakeholders’ approaches to economic decisions in DTx development, with prior studies also indicating limited consideration of economic factors in early DTx development stages, particularly from researchers. This study investigates how researchers approach decision-making regarding factors that influence the economic impact of DTx during technological development and clinical validation phases, examining the underlying mechanisms and contextual conditions that shape these processes. Using a critical realism philosophical stance, 17 semistructured interviews were conducted with researchers involved in DTx development, including research engineers (n=5), health systems and social science researchers (n=6), clinician-researchers (n=4), and practitioner-researchers (n=2). The research approach combined deductive and inductive coding, followed by abductive and retroductive inference processes to identify generative mechanisms underlying observed decision-making patterns. Qualitative system dynamics modeling was applied to visualize causal loop relationships through triangulated data sources. Three interrelated generative mechanisms were identified that shape researchers’ decision-making regarding economic considerations: (1) the professional norms, operating through reinforcing loops that systematically prioritize clinical validation while marginalizing economic considerations; (2) the researcher experience, revealing how professional training and limited economic literacy create cognitive biases that obscure economic factors; and (3) the DTx adoption uncertainties, demonstrating how implementation concerns influence development decisions through both reinforcing and balancing feedback loop dynamics. These mechanisms explain why, despite growing recognition of the importance of economic evidence, economic considerations remain peripheral in researchers’ decision frameworks. This study reveals complex interactions between institutional structures, intrapersonal factors, and implementation uncertainties that systematically deprioritize economic considerations in DTx development. The identified mechanisms provide valuable intervention points for strengthening the development process toward a more comprehensive assessment of clinical, technical, and economic value throughout the DTx lifecycle to ultimately enhance their adoption in health care systems.
10. Using Wearable Device and Machine Learning to Predict Mood Symptoms in Bipolar Disorder: Development and Usability Study.
期刊: JMIR medical informatics 发表日期: 2025-Sep-16 链接: PubMed
摘要
Bipolar disorder (BD) is a highly recurrent disorder. Early detection, early intervention, and prevention of recurrent bipolar mood symptoms are key to a better prognosis. This study aims to build prediction models for BD with machine learning algorithms. This study recruited 24 participants with BD. The Beck Depression Inventory and Young Mania Rating Scale were used to evaluate depressive and manic episodes, respectively. Using digital biomarkers collected from wearable devices as input, 6 machine learning algorithms (logistic regression, decision tree, k-nearest neighbors, random forest, adaptive boosting, and Extreme Gradient Boosting) were used to build predictive models. The prediction model for depressive symptoms achieved 83% accuracy, an area under the receiver operating characteristic curve (AUROC) of 0.89, and an F1-score of 0.65 on testing data. The prediction model for manic symptoms achieved 91% accuracy, an AUROC of 0.88, and an F1-score of 0.25 on testing data. With the interpretable model Shapley Additive Explanations, we found that relatively high resting heart rate, low activity, and lack of sleep may predict depressive symptoms. This study demonstrated that digital biomarkers could be used to predict depressive and manic symptoms. This prediction model may be beneficial for the early detection of mood symptoms, facilitating timely treatment and helping to prevent BD recurrence.
11. Comparative Effectiveness of Digital Health Technologies in Tuberculosis Treatment: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Sep-16 链接: PubMed
摘要
Tuberculosis (TB) treatment remains a critical global health challenge, as traditional standard of care (SoC) approaches face limitations in accessibility and efficacy. While digital health technologies (DHTs) offer promising solutions to address these gaps, limited evidence exists on their comparative effectiveness. This study systematically evaluates and compares the impact of diverse DHTs on improving TB treatment outcomes and adherence, aiming to identify optimal strategies across different patient populations. A systematic search was conducted across PubMed, Cochrane Library, Embase, and Web of Science from database inception through February 28, 2025, with no language restrictions. Eligible studies included randomized controlled trials comparing DHTs with SoC for TB treatment. The primary outcome was treatment success, defined as completion or cure. A random-effects network meta-analysis was performed, calculating odds ratios (OR) and 95% credibility intervals (CrI) to assess treatment effects. Surface under the cumulative ranking curve (SUCRA) values were used to rank intervention effectiveness. This study is registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42025601199). From 2420 screened studies, 27 randomized controlled trials involving 23,283 patients and eight DHT interventions were included. The network meta-analysis revealed that digital health platforms showed marginal improvements in treatment success (OR=3.44; 95% CrI 0.95-11.67; SUCRA=0.913; P=.05). Compared with SoC, video directly observed treatment (VDOT) significantly improved treatment success (OR=2.39; 95% CrI 1.18-4.75; SUCRA=0.848; P=.01). Medication event reminder monitors significantly enhanced treatment adherence (OR=3.13; 95% CrI 1.55-7.05; SUCRA=0.891; P=.003). Results underscore the significant potential of DHTs to improve TB treatment management. VDOT emerged as the most effective intervention for enhancing treatment success, while medication event reminder monitors demonstrated efficacy in sustaining adherence. Digital health platforms showed promise but require additional validation. Caution is warranted due to potential heterogeneity across studies, which may affect generalizability. This research offers actionable insights for stakeholders aiming to optimize TB management through strategic DHT integration.
12. Defining the Rates of Cytokine Release Syndrome Associated With Talquetamab Step-up Doses.
期刊: JCO oncology practice 发表日期: 2025-Sep-16 链接: PubMed
摘要
Talquetamab is a G protein-coupled receptor class C group 5 member D T-cell-engaging antibody, approved for relapsed/refractory multiple myeloma (RRMM). In the MonumenTAL-1 clinical trial, cytokine release syndrome (CRS) occurred at a frequency of 77%; however, there was no assessment of CRS rates by step-up dose. The primary objective of this study was to characterize CRS rates after each talquetamab step-up dose in a real-world setting. Patients with RRMM who completed the talquetamab once a week or once every 2 weeks step-up dosing schedule between September 2023 and November 2024 were identified via the institutional database. CRS rate after each talquetamab step-up dose was compared using the chi-square/Fisher’s exact test. The Kruskal-Wallis test was used to compare difference in median time to the CRS onset. Multivariate logistic regression analysis was performed to identify predictors of CRS. Fifty patients completed the talquetamab step-up dosing phase during the study period; CRS occurred at a rate of 80%. Pairwise comparisons revealed significant differences in CRS rates between the fourth dose (4%) and each of step-up dose 1 (28%, P = .014) and 2 (34%, P = .003). The only CRS event with fourth dose was grade 1. The median time to onset of first CRS did not differ significantly between step-up doses (P = .441). Previous exposure to T-cell-redirecting therapy had no impact on CRS incidence (odds ratio: 0.20 [95% CI, 0.03 to 1.10]). Our findings suggested that the fourth talquetamab dose could be administered in outpatient settings given its high tolerability. The reduced hospitalization period for talquetamab step-up dosing could reduce health care expenses.
13. Outcomes of a Needs Assessment: Informing the Development of an Infection Prevention and Control Toolkit for Missouri Schools.
期刊: The Journal of school nursing : the official publication of the National Association of School Nurses 发表日期: 2025-Sep-16 链接: PubMed
摘要
Effective infection prevention and control (IPC) in schools is vital for student and staff health, yet current resources often fall short, exhibiting a narrow focus, overemphasis on COVID-19, and fragmented implementation, excluding school nurses. This manuscript details a comprehensive needs assessment conducted with Missouri school staff and subject matter experts. Through existing data review, listening sessions, and interviews, the assessment identified critical gaps in IPC training, preferred delivery methods (e.g., self-paced online modules and multimodal formats), and distinct resource needs for various school audiences (e.g., administrators, teachers, students, parents, facilities, food services, transportation, and athletics). Findings highlight the necessity of tailored, accessible, and consistently messaged IPC resources, emphasizing the crucial, yet often underutilized, central role of school nurses. This needs assessment informed the development of a responsive IPC Toolkit for Missouri Schools, aiming to bridge existing gaps and enhance school-based IPC.
14. Psychometric Properties and Feasibility of PROMIS Computerized Adaptive Tests Compared with Disease-Specific Measures in Knee Arthroplasty.
期刊: The Journal of bone and joint surgery. American volume 发表日期: 2025-Sep-16 链接: PubMed
摘要
The efficient assessment of health outcomes in knee arthroplasty may benefit from universally applicable Patient-Reported Outcomes Measurement Information System computerized adaptive tests (PROMIS CATs), rather than disease-specific measures. This study aimed to evaluate and compare some psychometric properties and the feasibility of various PROMIS CATs (Pain Interference [PROMIS-PI-CAT, v1.1], Physical Function [PROMIS-PF-CAT, v2.0], Mobility [PROMIS-Mob-CAT, v2.0], Ability to Participate in Social Roles and Activities [PROMIS-AS-CAT, v2.0], and Satisfaction with Social Roles and Activities [PROMIS-SS-CAT, v2.0]), with the Knee Injury and Osteoarthritis Outcome Score (KOOS) scales, including the KOOS Physical Function Shortform [KOOS-PS] and KOOS for Joint Replacement [KOOS-JR], and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scales. Patients (n = 193; mean age [and standard deviation], 64.4 ± 10.1 years; 56% female; mean body mass index, 29.6 ± 5.2 kg/m2) undergoing unilateral or bilateral primary or revision knee arthroplasty at AZ Alma (Eeklo, Belgium) completed the measures 6 weeks before and 6 weeks and 3, 6, and 12 months after surgery. The study evaluated precision (standard error as a percentage of scale range [SE%]), responsiveness (hypothesized correlations and standardized response mean [SRM]), floor and ceiling effects (percentage with the worst and the best scores), and feasibility (completion time and number of items). The PROMIS-PI-CAT and PROMIS-PF-CAT showed better precision at baseline compared with corresponding KOOS/WOMAC scales (SE%, 4.6 versus 7.1/9.3 and 3.6 versus 4.4/4.4), but less precision at 12 months of follow-up (SE%, 6.8 versus 4.8/5.5 and 3.6 versus 3.0/3.0). All PROMIS CATs had good responsiveness (75% to 100% of hypotheses not rejected; SRMs at 12 months: PROMIS-PI-CAT = -1.35 versus KOOS Pain = 1.78 and WOMAC Pain = -1.59; PROMIS-PF-CAT = 1.14 versus KOOS-ADL/WOMAC-PF = 1.43/-1.44; PROMIS-AS-CAT = 0.93 and PROMIS-SS-CAT = 0.93). The PROMIS-PF-CAT did not show ceiling effects at 12 months, unlike the KOOS-ADL/WOMAC-PF (17.5%). PROMIS CATs were more feasible at baseline and follow-ups compared with KOOS and WOMAC scales. PROMIS-CATs effectively assess health outcomes in knee arthroplasty patients, showing strong psychometric properties and favorable feasibility, supporting their role in value-based health care. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
15. Online Social Support for Medicaid-Eligible Pregnant Women.
期刊: MCN. The American journal of maternal child nursing 发表日期: 2025-Sep-16 链接: PubMed
摘要
Medicaid-eligible pregnant women are a chronically stressed population with various negative perinatal effects due in part to their challenging financial status. Increasingly, they use social media to obtain social support; however, experiences of using social media for social support are unknown. The purpose of this study was to explore experiences of Medicaid-eligible pregnant women using Facebook groups. Semistructured interviews of pregnant women who used Facebook groups for social support were conducted. Eligibility or insurance coverage by Medicaid was considered as a proxy for low socioeconomic status. Thematic analysis was completed. Fourteen pregnant women were interviewed. Several themes were identified. The overarching theme was social support through an online community, connections, and information support with affirmation woven through to build connections. Participants felt nurses, midwives, and physicians should recommend Facebook groups to obtain social support. Most participants found their experiences via Facebook overwhelmingly positive, even if they had some negative encounters. Participants found social support via Facebook groups. Recommendations for nurses include recognizing social media as a venue to access social support, starting peer-led communities for Medicaid-eligible women using social media, and engaging in policy work on social media recommendations for pregnant women. It is unknown what effect this social support has on their chronic stress.
16. Violence, Discrimination, and Mental Health Among Asian Americans: Findings From a 2023 Statewide Cross-Sectional Survey From California.
期刊: Journal of interpersonal violence 发表日期: 2025-Sep-16 链接: PubMed
摘要
17. Architect Insights: Implications and Barriers of Future-Proofing Hospitals.
期刊: HERD 发表日期: 2025-Sep-16 链接: PubMed
摘要
Aim: This study explores how future-proofing is understood and applied in hospital building design, focusing on the perspectives of experienced architects. It aims to examine the practical implications of future-proofing and to identify key barriers to its implementation within contemporary healthcare infrastructure projects. Background: Existing literature often focuses on the general benefits, such as cost savings and sustainability, but lacks detailed analysis of the multifaceted implications and obstacles encountered in real-world projects. This study addresses this gap by directly examining architects’ perspectives, offering critical insights into the practical realities and complexities of future-proofing hospital buildings, thereby contributing to a more nuanced understanding and informed decision-making in this field. Methods: Sixteen semistructured interviews were conducted with experienced hospital architects based in Australia. Data were analyzed using a combination of deductive and inductive thematic analysis. Results: The results of thematic analysis have been categorized under three overarching categories: perceived benefits, perceived drawbacks, and implementation challenges. The findings highlight that future-proofing is neither inherently beneficial nor burdensome, but rather a context-sensitive strategy that must be tailored to each project’s evolving operational, economic, and policy. Conclusions: The study underscores the need for more systematic, longitudinal evaluation of future-proofing strategies, as well as greater integration of advanced futures methodologies into healthcare planning and design processes. A more structured and evidence-based approach to future-proofing can support the development of hospital infrastructure that is both resilient and responsive to the long-term evolution of healthcare systems.
18. Moving for Minutes: A Health Promotion Exemplar for Employee Wellness at a School of Nursing.
期刊: Workplace health & safety 发表日期: 2025-Sep-16 链接: PubMed
摘要
Although physical activity is widely acknowledged as essential for health, achieving work-life balance for faculty and staff at the school of nursing, who work long hours, can be challenging, often leading to the neglect of regular exercise, a crucial element of personal health and wellness. To address this issue, a staff member initiated the “Moving for Minutes” program (M4M) in 2009, aimed at encouraging weekly physical activities such as walking, jogging, biking, and swimming among the faculty and staff. The M4M program operates on a quarterly basis, with participants grouped into teams and asked to track their weekly physical activity minutes. At the end of each quarter, a brief celebration takes place, where healthy snacks are served, and inexpensive prizes are awarded to individuals and teams with the most logged minutes. Since its inception 15 years ago, 128 faculty and staff members have participated, with an average of 18 participants per quarter, representing about 20% of the school of nursing workforce. Participants’ mean engagement was 273 minutes of physical activity per person per week of the program. Overall, the M4M program has proven to be highly beneficial by promoting a healthy work environment, encouraging self-care, boosting morale, and fostering camaraderie among faculty and staff at the school of nursing. The M4M program provides an exemplar of successfully supporting physical activity, and promoting general health and well-being among employees.
19. NutriMine: Evaluation of a Serious Game Modification for Minecraft Aimed at Educating and Promoting a Healthy Diet.
期刊: Games for health journal 发表日期: 2025-Sep-16 链接: PubMed
摘要
Background: Overweight and obesity are growing concerns and significant risk factors for noncommunicable diseases, especially in industrialized nations, necessitating innovative intervention strategies. Serious games designed to provide education and effectively promote behavior change have emerged as a potential solution. Methods: This research assesses a serious game developed as a modification of the popular video game “Minecraft” called “NutriMine.” This modification was created based on identified requirements from a nutrition expert through a qualitative interview and a preliminary evaluation conducted in a pilot study with 11 users. Additionally, a playtest and evaluation with 20 participants from the target group, incorporating the user engagement scale (UES), system usability scale (SUS), and game experience questionnaire (GEQ), was conducted. Results: The results indicated a satisfactory level of engagement. Overall, findings also revealed positive feedback concerning the SUS (75% of participants scored above 70) and UES (75% of participants scored above 3), with most results positioned in the upper half for both scales. The evaluation using the GEQ yielded generally positive outcomes, with minor concerns related to “competence,” “flow,” and “immersion” due to the varying levels of Minecraft experience among participants. The combined results of the evaluation led to the formulation of requirements for a serious game modification in the area of nutrition. Conclusion: The results highlight the modification’s potential for larger-scale use as an effective behavior change tool for individuals seeking to maintain a healthy diet.
20. SEOM-AEEMT consensus on occupational cancer and cancer-associated disability.
期刊: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 发表日期: 2025-Sep-16 链接: PubMed
摘要
Cancer is one of the main causes of morbidity and mortality in Spain and has a significant impact in the workplace, where exposure to carcinogens in the work environment can increase the risk of developing this disease. The lack of communication between oncologists and occupational physicians limits the accurate assessment of cancer as an occupational disease and as a cause of disability. In 2020, the Spanish Society of Medical Oncology (SEOM) and the Spanish Association of Occupational Medicine Specialists (AEEMT) launched a joint initiative to strengthen prevention, reporting, and management of occupational cancer. This consensus provides a structured framework for assessing the occupational origin of cancer, facilitating case notification and classification as occupational contingencies, and supporting informed evaluations of disability and work reintegration in patients with cancer. The collaboration between both societies aims not only to advance occupational cancer prevention but also to promote evidence-based strategies for return-to-work planning.
21. Evidence for the Use of Patient-Reported Outcome Measures in the Treatment of Patients With Noncommunicable Diseases: Systematic Review.
期刊: JMIR medical informatics 发表日期: 2025-Sep-16 链接: PubMed
摘要
The use of patient-reported outcome measures (PROMs) as a clinical tool for screening and decision-making has gained widespread interest, with numerous implementation activities across specialties, even though the evidence has not been clear until now. The aim of this study was to assess the evidence for using PROMs in clinical practice for patients with diabetes, chronic obstructive pulmonary disease (COPD), heart disease, rheumatoid arthritis (RA), and inflammatory bowel disease (IBD). Additionally, we sought to determine the characteristics of the most effective PROM interventions. We conducted a systematic review of published randomized controlled trials (RCTs) on the use of PROMs for clinical purposes, such as systematic PROM assessment alone or with a predefined PROM-based decision-making method. Eligible studies included adult patients (>18 years) with diabetes, COPD, heart disease, RA, or IBD. We excluded studies using PROMs as an outcome measure or otherwise not meeting the inclusion criteria. We searched the PubMed/MEDLINE, CINAHL, EMBASE, and Web of Science databases until February 2023. Two investigators independently screened titles, abstracts, and relevant full texts. Three investigators completed data extraction and risk-of-bias assessment using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The data were presented in a narrative synthesis and in summarized form. The search yielded 21,203 papers, 686 (3.2%) full-text papers were screened, and 56 (8.2%) original studies were included in the review. The studies included patients with heart disease (n=17, 30.4%), COPD (n=13, 23.2%), diabetes (n=10, 17.9%), IBD (n=9, 16.1%), and RA (n=6, 10.7%), as well as patients with mixed diagnoses (n=1, 1.8%). All interventions incorporated systematic PROM assessments. Some interventions additionally used a predefined method for PROM-based decision-making (n=19, 33.9%) or PROM-based dialogue (n=9, 16.1%), while 5 (8.9%) interventions aimed to substitute face-to-face consultations. The predominant mode of PROM administration was over the phone, followed by electronic devices and apps. Endpoints included disease activity, health care use, mortality, mental well-being, quality of life, self-efficacy, self-care, daily functioning, and other outcomes. Six studies with a low risk of bias demonstrated a positive effect or noninferiority of the PROM intervention. The evidence base for clinical use of PROMs is sparse, with few studies evaluated to have a low or a medium risk of bias. The clinical use of PROMs does not appear superior to usual care in the five included chronic diseases on any endpoint. To guide further research, we highlighted 6 (10.7%) studies with a low risk of bias and PROM interventions with a positive effect. These were characterized by symptom assessment with predefined cutoffs used for decision and dialogue support. PROSPERO CRD42021226896; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021226896.
22. Exploring Pain on Social Media: Observational Study on Perceptions and Discussions of Chronic Pain Conditions.
期刊: JMIR infodemiology 发表日期: 2025-Sep-16 链接: PubMed
摘要
Chronic pain, affecting 30.3% of the global population, constitutes a major public health and social challenge. It is associated with disability, emotional distress, and diminished quality of life. Conditions, such as fibromyalgia, headache, paraplegia, neuropathy, and multiple sclerosis are characterized by persistent pain and limited social and medical understanding. This contributes to patient isolation and increases mental health burden. In recent years, social media, particularly X (formerly Twitter), has emerged as a key space for analyzing health-related perceptions and experiences. Its massive use, spontaneity, and broad reach have made these platforms a valuable source for infodemiological research. This study aims to analyze posts on X concerning fibromyalgia, headache, paraplegia, neuropathy, and multiple sclerosis, as well as characterize the profile of users involved in these conversations, identify prevalent topics, measure public perception, evaluate treatment efficacy, and detect discussions related to the most frequent nonmedical issues. A total of 72,874 tweets in English and Spanish containing the selected keywords were collected between 2018 and 2022. A manual review of 2500 tweets was conducted, and the larger subset was automatically classified using natural language processing methods based on the BERTweet model, previously fine-tuned for content analysis on social media platforms. Subsequently, tweets related to chronic pain conditions were analyzed to examine user types, disease origin, and both medical and nonmedical content. Of the total tweets collected, 55,451 (76.1%) were classifiable. The most active users were health care professionals and institutions. The primary perceived etiology was pharmacological, and higher treatment efficacy was noted in neuropathy, paraplegia, and multiple sclerosis. Regarding nonmedical content, there were more tweets related to the definition and understanding of the disease. Social media platforms, such as X, are playing a crucial role in the dissemination of information on chronic pain. Discussions largely focus on the available treatments and the need to enhance public education, using these platforms to correct misconceptions and provide better support to patients.
23. Environmental noise exposure and a new biomarker of Alzheimer's disease: A pilot study.
期刊: Journal of Alzheimer’s disease : JAD 发表日期: 2025-Sep-16 链接: PubMed
摘要
BackgroundEnvironmental noise pollution is increasingly recognized as a contributor to neurodegenerative processes, yet its relationship with early Alzheimer’s disease biomarkers remains unclear.ObjectiveThis pilot study aimed to assess the feasibility of using gray-to-white matter signal intensity contrast (GWC) as a potential biomarker to explore associations between environmental noise exposure and early neurodegenerative changes.MethodsA total of 106 participants (mean age 35.97 ± 9.21 years, range 20-55), without cognitive impairment or neurological disorders, were included. Environmental noise levels were estimated using spatial interpolation from the National Noise Information System. Based on WHO guidelines (>60 dB daytime or >55 dB nighttime), participants were categorized into high- and low-noise groups. Whole-brain and regional GWC values were derived from 3D T1-weighted MRI using FreeSurfer. Correlations between noise exposure and GWC were analyzed with Pearson’s correlation.ResultsThe high-noise group exhibited elevated whole-brain GWC values (20.11 ± 0.93) compared with the low-noise group (19.68 ± 0.96; p = 0.036). Regional analyses revealed higher GWC in the superior frontal gyrus, precentral gyrus, and paracentral lobules (all p < 0.05, FDR corrected). Nighttime noise exposure correlated more strongly with increased GWC (r = 0.203, p = 0.037) than daytime exposure.ConclusionsThis pilot study provides preliminary evidence of an association between environmental noise-particularly nighttime exposure-and subtle structural brain changes, as indicated by elevated GWC values. These findings suggest a potential neurobiological pathway linking noise exposure to early markers of neurodegeneration, warranting validation in larger, longitudinal studies.
24. Evaluation of Immune Risk Factors for Developing Complications After Bacterial Meningitis in Children.
期刊: Journal of child neurology 发表日期: 2025-Sep-16 链接: PubMed
摘要
This study investigates selected components of the immune system and the prevalence of single-nucleotide polymorphisms in genes involved in the immune response in children following bacterial meningitis, with particular focus on their potential role in the development of postinfectious complications. The study included 47 children hospitalized with pneumococcal or meningococcal meningitis between 2010 and 2020. Analyses involved leukocyte profiles, immunoglobulin levels (IgA, IgM, IgG), complement activity (C3, C4, CH50), and 11 single-nucleotide polymorphisms across 7 genes. Data on complications were collected from medical records, follow-ups, and patient surveys. Complications occurred in 59.6% of cases, with cognitive impairment, focal neurologic deficits, subdural effusion, and hearing disorders being most common. CH50 defects showed a statistical trend toward an increased risk of neurologic complications (P = .064), and the TIRAP rs8177374 single-nucleotide polymorphism demonstrated a borderline trend toward significance (P = .054). Bacterial meningitis may lead to long-term complications. Complement system disturbances and genetic predispositions are important prognostic factors influencing outcomes.
25. Two-Dimensional LC × DMS Analysis of 34 PFAS Compounds.
期刊: Analytical chemistry 发表日期: 2025-Sep-16 链接: PubMed
摘要
Per- and polyfluoroalkyl substances (PFAS) are ubiquitous environmental pollutants that pose potential risks to ecosystems and human health. Prior to mass spectrometric analysis of environmental samples, it is necessary to separate PFAS from compounds that can cause ion suppression and compromise analyte identification and quantification accuracy. Although liquid chromatography-mass spectrometry (LC-MS) is the gold standard for PFAS trace analysis, some PFAS species still coelute in the LC dimension and could benefit from an orthogonal dimension of separation. Moreover, an additional orthogonal dimension of separation could potentially aid in the identification of unknown fluorinated species (e.g., those identified within a specified mass-defect range). Here, we investigate the sequential use of LC and differential mobility spectrometry (DMS) separation to analyze 34 PFAS species. Upon incorporating DMS in a two-dimensional (2D) separation scheme, we observed baseline resolution of 29 compounds in the 2D LC × DMS space, with partial resolution of the remaining five. In comparison, only five PFAS compounds were baseline-resolved in 1D LC experiments. Because DMS measurements can be acquired in milliseconds, targeted 2D LC × DMS-MS2 analyses operate on the same time scale as LC-MS2 analysis. However, the limits of quantitation for PFAS using the 2D LC × DMS-MS2 method are slightly higher than those achieved by the state-of-the-art LC-MS2 method owing to ion fragmentation within the energetic DMS environment. Nevertheless, distinct trends observed in the 2D separation space for the various PFAS subclasses will facilitate analyte identification of unknown species in future nontargeted analyses. Finally, we assessed the feasibility of our method for quantifying PFAS in a series of wastewater samples obtained from a Southern Ontario wastewater treatment plant. We were successful in quantifying PFOS, although the concentrations determined were consistently higher than those measured with LC-MS2.
26. Gas Phase Thermochemistry for Perfluoroalkyl Carboxylic Acids.
期刊: The journal of physical chemistry. A 发表日期: 2025-Sep-16 链接: PubMed
摘要
Perfluorinated species have become ubiquitous due to their desirable industrial properties including thermal and chemical stability, water resistance, and stain resistance. Despite their utility and widespread use, a number of PFAS have been identified as significant environmental contaminants posing health hazards. Much of the current studies are targeted to understand the fate and distribution of PFAS in water and solid interfaces. In contrast, the current insight into the thermodynamic properties of PFAS is minimal but play a critical role for modeling their reactions. In this study, the thermodynamic energies of perfluoroalkanoic acids (CnF2n+1OOH) have been predicted. The correlation consistent Composite Approach (ccCA) and coupled-cluster singles, doubles, with triple excitation (CCSD(T)) methods have been utilized to determine enthalpies of formation and Gibbs free energies including corrections for the conformational ensemble at 298 K. In addition, density fitted and local natural orbital coupled cluster approaches have been used to allow for the evaluation of larger PFAS with the ccCA composite. Thermodynamic predictions made using DFT(B3LYP) have also been evaluated in comparison to ccCA and CCSD(T) energetics due to its widespread usage in computing thermochemical properties.
27. Multistate Outbreak of Salmonella Thompson Infections Linked to Diced Onions-2023.
期刊: Foodborne pathogens and disease 发表日期: 2025-Sep-16 链接: PubMed
摘要
Since 2020, more than 2000 illnesses have been linked to foodborne outbreaks associated with onions. In 2023, the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention, and state partners investigated a multistate outbreak of Salmonella Thompson infections linked to diced onions grown and processed in California. The outbreak resulted in 80 ill people, 18 hospitalizations, and one death reported in 23 states. FDA conducted a traceback investigation that included three illness clusters comprised of five total ill people from four Long-Term Care Facilities. Three inspections, each accompanied by sampling, were conducted at Processor A, Grower A, and Packing Shed A, respectively. The FDA analyzed 18 samples, six of which yielded Salmonella spp. isolates. Isolates recovered from water, sediment, and piping below irrigation equipment, near the growing environment, matched the outbreak strain. Additional isolates recovered from environmental samples matched eight Salmonella Saintpaul clinical isolates from 2022, four Salmonella Infantis clinical isolates from four states from 2022 to 2023, and two unrelated Salmonella Newport clinical clusters from 2021 to 2023. Laboratory, traceback, and epidemiological evidence indicated onions grown in three specific fields as the source of the outbreak, suggesting that the outbreak strain was present at the farm level, established in the soil, and potentially disseminated through agricultural water. Further processing into diced onions could have also spread and/or amplified the pathogen in the product due to the practices and conditions at the processor. This investigation highlighted the importance of outreach and education to enhance onion industry food safety practices and prevent future outbreaks. It also emphasized the need for focused research on onion industry practices, including growing, harvesting, curing, processing, packing, and holding.
28. Racial and Ethnic Disparities in Outcomes following Preemptive Kidney Transplant Waitlisting in the United States from 2009-2024.
期刊: Journal of the American Society of Nephrology : JASN 发表日期: 2025-Sep-16 链接: PubMed
摘要
Preemptive kidney transplantation (prior to dialysis initiation) is the optimal therapy for most transplant-eligible advanced CKD patients. While prior research has documented racial and ethnic disparities in preemptive referrals, less is known about distinct outcomes following preemptive waitlisting. This study examines the association between race and ethnicity and outcomes for preemptively waitlisted patients. We conducted a secondary analysis of a prospectively maintained U.S. cohort using data from the Scientific Registry of Transplant Recipients (SRTR). The study population included 98,863 adult first-time kidney transplant candidates who were preemptively waitlisted from January 1, 2009, to December 31, 2020, and followed through December 31, 2024. The exposure of interest was race and ethnicity. The primary outcome was three-year preemptive deceased donor kidney transplantation, living donor kidney transplantation, or dialysis initiation. We used competing risk models to estimate adjusted subdistribution hazard ratios (aSHRs). Data were stratified into three-year intervals (2009-2011, 2012-2014, 2015-2017, and 2018-2020). Black and Hispanic patients received preemptive deceased donor kidney transplants as often as White patients (era 2018-2020, aSHRs [95% CI]: 0.99 [0.92-1.07] and 1.02 [0.93-1.12], respectively), while Asian patients had lower rates (0.78 [0.69-0.88]). However, Asian, Black, and Hispanic patients were more likely to initiate dialysis (aSHRs: 1.50 [1.39-1.61]; 1.41 [1.34-1.49]; and 1.21 [1.14-1.29], respectively) and were less likely to receive preemptive living donor kidney transplants than White patients (era 2018-2020, aSHRs: 0.49 [0.44-0.54]; 0.31 [0.29-0.34]; and 0.61 [0.56-0.66], respectively). Among waitlisted CKD patients in the U.S between 2009 and 2020, rates of preemptive deceased donor kidney transplantation improved for Black and Hispanic patients and became comparable to White patients. However, Asian, Black, and Hispanic patients experienced higher rates of dialysis initiation and lower rates of preemptive living donor kidney transplantation.
29. Eco-Friendly Conformal and Self-Adhesive Electrochemical Sensors for Sweat Monitoring.
期刊: ACS applied materials & interfaces 发表日期: 2025-Sep-16 链接: PubMed
摘要
Wearable sweat-sensing platforms represent a transformative advancement in noninvasive, real-time health monitoring, enabling personalized healthcare. For in vivo applications, sensor substrate materials require biocompatibility, secure adhesion, and, preferably, environmental sustainability. However, existing substrate materials fail to meet some of those requirements. This study introduces bacterial cellulose (BC) as a novel sensor substrate, leveraging its printability, biocompatibility, self-adhesion, and eco-friendliness. A wearable sweat sensor was fabricated by screen-printing conductive inks onto BC films. A key challenge addressed was the hydrophilicity of BC, which can cause liquid penetration and disrupt signal stability. To solve this, an approach was developed where the electrical tracks are sandwiched between two hydrophobic layers to fully avoid liquid interference and ensure stable electrochemical performance. The sensor was further functionalized with the alcohol oxidase enzyme to enable reliable alcohol detection in sweat at the relevant concentration range. This work demonstrates the feasibility of BC-based sensors for their application in wearable health monitoring, meanwhile promoting sustainable technological innovations in personalized healthcare and well-being technologies.
30. The Effectiveness of the Back At work After Surgery (BAAS) Work-Integrated Care Pathway on Return to Work for Patients Receiving Knee Arthroplasty: A Study of Three Comparative Cohorts in the Netherlands.
期刊: Journal of occupational rehabilitation 发表日期: 2025-Sep-16 链接: PubMed
摘要
Considering the increase in the demand from working age patients seeking knee arthroplasty (KA) and the low return-to-work (RTW) rates, optimization of care for patients getting KA with a focus on RTW is essential. We evaluated a work-integrated care pathway-Back At work After Surgery (BAAS)-aimed at improving RTW compared with care-as-usual in the Netherlands. In this multicenter study of three comparative cohorts, working patients who had primary KA were included. Patients in two Dutch hospitals (BAAS cohort) received integrated medical and occupational care, including structured pre- and postoperative consultations, goal setting, activity tracking, and interdisciplinary team meetings with both medical and occupational health professionals. Two independent control cohorts with comparable patient inclusion criteria (Expect TO work and ACTIVE) from 15 hospitals/clinics received care-as-usual. The primary outcomes were the time to first day of RTW and time to full RTW within 12 months. Inverse Probability of Treatment Weighting was used with known prognostic factors as covariates to account for possible differences in baseline characteristics. A total of 457 patients were included (BAAS n = 145; Expect TO work n = 179; ACTIVE n = 133). The median time to first day of RTW was 16-25 days shorter in the BAAS cohort (27 days) compared to Expect TO work (52 days; hazard ratio [HR] 2.7; 95% confidence interval [CI]:2.1-3.4) and ACTIVE cohort (43 days; HR:1.95; CI:1.5-2.6). At three months, 90% of BAAS patients had started RTW versus 63% and 77% in the control cohorts. BAAS patients also achieved full RTW earlier, with a median time reduced by 27 days compared to the ACTIVE cohort (HR:1.4; CI:1.1-1.8). The odds of full RTW at 12 months were higher in the BAAS cohort compared to Expect TO work, namely odds ratio (OR) 5.0 (CI:1.3-18.5) and ACTIVE OR 9.3 (CI:2.5-34.8). The BAAS work-integrated care pathway was more effective than care-as-usual in improving RTW after KA in the Netherlands. This study was retrospectively registered at clinicaltrails.gov ( https://clinicaltrials.gov/ct2/show/NCT05690347 , date of first registration: 19-01-2023).
31. A Cross-Sectional Study Assessing Pulmonary Function Differences in Diabetic Versus Non-Diabetic Mine Workers in Gujarat: Implications for Establishing Mining Cohort.
期刊: Workplace health & safety 发表日期: 2025-Sep-16 链接: PubMed
摘要
Diabetes, a significant global health concern, affects one in 10 adults, with many unaware. Despite its prevalence, evidence on its impact on pulmonary function is limited. Given the occupational exposure to silica dust, mine workers may face heightened pulmonary risks with diabetes. Our objective was to estimate differences in pulmonary functions between diabetic and non-diabetic mine workers and determine predictors of pulmonary dysfunction. We conducted a cross-sectional study of 215 mine workers from Gujarat’s lignite mines in December 2021. Data on demographics, occupation, comorbidities, anthropometry, blood pressure, and random blood glucose (RBG) were collected. Diabetes was defined as self-reported history or RBG ≥200 mg/dL with symptoms. Spirometry measured forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Group differences were analyzed using independent t-tests, and linear regression identified predictors of pulmonary function. Diabetic workers (18%) exhibited lower FEV1 (2.80 ± 0.65 vs. 3.11 ± 0.77 L, p = .022) and FVC (3.21 ± 0.69 vs. 3.55 ± 0.84 L, p = .017). On linear regression, male gender and longer work experience significantly predicted FEV1 and FVC, while adjustments for confounding variables diminished diabetes’s impact. Lower FEV1 and FVC among diabetic mine workers suggest a potential role of diabetes in pulmonary impairment. The diminished effect after adjustment underscores the need for mining cohorts to confirm these findings. Mine workers should undergo annual diabetes screening and respiratory evaluations beyond routine periodic medical examinations. Workplace programs targeting non-communicable diseases should be implemented to support long-term worker health.
32. Prevalence, determinants and outcomes of low disease activity and remission attainment in SLE patients with clinically active disease.
期刊: Arthritis care & research 发表日期: 2025-Sep-16 链接: PubMed
摘要
This study aimed to identify the frequency and determinants of Lupus Low Disease Activity State (LLDAS) and Definition of Remission in SLE (DORIS-remission) attainment in systemic lupus erythematosus (SLE) patients with clinically active disease, and the frequency and determinants of flare and damage accrual after target attainment. Patients in a multi-national SLE cohort who had clinical disease activity but were not in LLDAS or DORIS-remission were followed prospectively. 1991 patients (93.2% female) were followed for a median (IQR) of 2.5 (0.7-4.5) years, with 70.9% and 55.6% achieving LLDAS and DORIS-remission, respectively. Nephritis and low complements were associated with a longer time, and antimalarial and immunosuppressant use were associated with a shorter time to LLDAS attainment. After the first LLDAS and DORIS-remission attainment, 47.0% and 47.5% of the patients experienced flare(s), respectively, and 9.5% and 7.9 % of patients accrued organ damage within 24 months, respectively. Longer cumulative time at target and antimalarial use was associated with a longer time to flare and damage accrual, while dose reduction in glucocorticoids and immunosuppressants was associated with a shorter time to flare. Reduction in immunosuppressants also correlated with a shorter time to damage accrual. In SLE patients with clinical disease activity, the proportion attaining LLDAS and DORIS-remission under usual care conditions is suboptimal. Longer maintenance of these states is significantly associated with reduced risk of flare. As flares and damage accrual still occur frequently following initial target attainment, further research is needed to inform strategies for maintaining these targets.
33. Quality of Life in Paediatric Food Allergy: Diverging Influences on Parent and Child Reports in the ROAD Study.
期刊: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 发表日期: 2025-Sep-16 链接: PubMed
摘要
34. The Cost-Effectiveness of the Cancer Home-Life Intervention: An Economic Evaluation Alongside a Randomized Clinical Trial with a Six-Month Time Frame.
期刊: Journal of palliative medicine 发表日期: 2025-Sep-16 链接: PubMed
摘要
Background: People with advanced cancer often face significant challenges in everyday activities, especially within their home environments, where they spend most of their time. The Cancer Home-Life Intervention is an occupational therapy-based program supporting everyday activities in people with advanced cancer living at home. Aim: To examine the cost-utility and cost-effectiveness of the Cancer Home-Life Intervention compared to usual care over six months. Methods: This economic evaluation with a societal perspective was conducted alongside a randomized controlled trial (ClinicalTrials.gov: NCT02356627). Quality-adjusted life years (QALYs) and activities of daily living motor ability accounted for the outcome. Costs included primary and secondary health care, domestic care, assistive devices, and participants’ out-of-pocket costs. A total of 242 adults with advanced cancer were included from two Danish University Hospitals and randomized 1:1 to the Cancer Home-Life Intervention or usual care. Primary analysis included 172 participants alive at six months follow-up. Results: The intervention showed no statistically significant improvement in either QALYs or activities of daily living motor ability compared to usual care. However, the cost-utility analysis revealed a 72% probability of the intervention being cost-effective, regardless of the willingness-to-pay threshold per QALY gained. The probability of cost-effectiveness for activities of daily living motor ability started at 26% and increased to 58%. Sensitivity analyses supported these findings. Conclusion: The Cancer Home-Life Intervention showed limited potential for cost-effectiveness compared to usual practice. The cost-utility analysis revealed a 72% probability of cost-effectiveness. However, these findings should be interpreted cautiously due to small, nonstatistically significant improvements in QALYs.
35. Do Postoperative Outcomes of Surgical Treatment for Spinal Metastasis Differ by Institutional Function?: Analysis of a Nationwide Administrative Database in Japan.
期刊: Clinical spine surgery 发表日期: 2025-Sep-15 链接: PubMed
摘要
Retrospective comparative study. To investigate the impact of institutional function (cancer center and surgical volume for spine surgery) on in-hospital outcomes after surgical treatment for spinal metastasis using a nationwide administrative database. Multidisciplinary approaches to bone metastasis have become common in Japan, especially in cancer centers. However, whether treatment outcomes for spinal metastasis surgery differ by institutional function remains controversial. Data of patients who underwent surgical procedures for spinal metastasis between 2012 and 2020 were extracted from the Diagnosis Procedure Combination database. In-hospital outcomes included in-hospital mortality, 30-day mortality, length of stay until discharge home, postoperative complications, and unfavorable ambulatory status. Univariate and multivariate analyses were performed to investigate the association between cancer center/surgical volume and each outcome while adjusting for potential confounders. A total of 10,320 patients were included in this study. Among them, 5261 patients were treated at cancer centers. The median annual surgical volume for spine surgery was 166 cases. The 30-day mortality was lower in cancer centers than in noncancer centers [odds ratio (OR): 0.841, 95% CI: 0.709-0.999, P=0.0483] and in high-volume hospitals for spine surgery than in low-volume hospitals (OR per 50 cases: 0.958, 95% CI: 0.928-0.990, P=0.0101). The length of stay until discharge home, postoperative complications, and postoperative unfavorable ambulatory status did not differ by cancer center or surgical volume. The short-term mortality was lower in cancer centers or high-volume hospitals, whereas postoperative complications and ambulatory outcomes did not differ by institutional function. A deeper understanding of the multidisciplinary approaches or processes of care adopted at these institutions might be important to deliver similar outcomes in other hospitals to patients with spinal metastasis. Level III.
36. Examination of the Association Between History of Self-Reported Mild Traumatic Brain Injury and Neurocognitive Performance.
期刊: The Journal of head trauma rehabilitation 发表日期: 2025-Sep-11 链接: PubMed
摘要
To examine whether pediatric mild traumatic brain injury (mTBI) is associated with differences in neurocognitive functioning among children. Baseline data from the Adolescent Brain Cognitive Development (ABCD) Study. Children with mTBI were compared to two control groups: children with orthopedic injury (OI) and children with no injury (NI). After excluding those with moderate/severe TBI, 450 children were classified as having mTBI, 1604 with OI, and 9814 with NI. This is a cross-sectional analysis using the baseline data from a longitudinal observational study. Neurocognitive performance was assessed using task-based cognitive tests, including the National Institutes of Health Toolbox Cognition Battery (NIHTBX), Rey Auditory Verbal Learning Test, and the Little Man Task. Multiple imputation was used to address missing data. Linear regression models were used to compare cognitive performance across groups, adjusting for age, sex, race, ethnicity, parental income, parental education, and genetic ancestry. The primary outcomes include the principal component scores representing General Ability, Executive Function, and Learning/Memory. Unadjusted analyses showed children with mTBI had significantly higher scores than NI children on all three principal components. However, no significant differences remained after adjusting for confounders. No differences were found between mTBI and OI groups. Sensitivity analyses further adjusting for behavior and white matter microstructure resulted in same findings. After adjusting for demographic and genetic factors, no significant differences were found between children with mTBI and OI/NI. The findings highlight the importance of accounting for demographic, socioeconomic, and genetic confounders, as well as selecting appropriate control groups, when analyzing cognitive differences of children with mTBI.
37. Association between Visual, Hearing and Dual Sensory Impairment and the Frailty Syndrome.
期刊: Aging and disease 发表日期: 2025-Sep-09 链接: PubMed
摘要
Sensory loss has been associated with multiple adverse health conditions. However, the combined effect of visual and hearing impairment on frailty is unknown. The aim of this study was to examine the association between visual, hearing, and dual-sensory impairment and frailty prevalence. This cross-sectional study investigated 105,406 participants aged ≥39 years from the UK Biobank study. Visual acuity was measured with a chart, as the logarithm of the minimum angle of resolution (LogMAR); functional auditory capacity was measured with a digit triplet test, as the speech reception threshold in noise (SRTn). Dual sensory impairment was defined as the presence of both visual impairment (LogMAR &;gt 0.3 units) and hearing impairment (SRTn ≥ -5.5 dB SNR). To define the frailty syndrome, two methods were used, the frailty phenotype and the FRAIL scale. Analyses were conducted using logistic models adjusted for relevant confounders. Among the participants, 54.3% were women, with a mean age of 56.8 years (SD: 8.1, range 39 to 72). The prevalence of frailty was 3.5%, defined with the frailty phenotype, and 3.6%, using the FRAIL scale. For visual impairment, the OR (95% CI) of frailty was 1.51 (1.28-1.79) for the frailty phenotype, and 1.31 (1.10-1.57), for the FRAIL scale. For hearing impairment, in comparison with having normal hearing, the OR (95% CI) associated with insufficient and poor hearing were 1.32 (1.20-1.45) and 1.83 (1.53-2.19), respectively for the frailty phenotype, and 1.32 (1.19-1.46) and 1.93 (1.60-2.33) for the FRAIL scale. Estimates for the association between dual-sensory impairment and frailty were 2.22 (1.65-2.99) for the frailty phenotype, and 1.73 (1.23-2.42) for the FRAIL scale. Visual and hearing impairments were related to frailty. Having dual-sensory impairment was associated with twice the likelihood of frailty syndrome in comparison with having none of them.
38. Fever Induces Long-Term Synaptic Enhancement and Protects Learning in an Accelerated Aging Model.
期刊: Aging and disease 发表日期: 2025-Sep-04 链接: PubMed
摘要
The physiological impact of fever on the brain remains poorly understood. Here, we demonstrate that temperature increases by yeast injection in rats (N=9) and by whole-body hyperthermia in mice (N=7) triggers structural synaptic enhancement in the prefrontal cortex through a mechanism involving AMPA-type glutamate receptors and protein translation (N=6). Repeated pyrexia induction in juvenile rats (N=9) results in synaptic strengthening that persists into adulthood, mitigating learning deficits and synaptic loss in a D-galactose model of accelerated aging (N=9-11). Our results show how common environmental conditions may shape brain function in the long-term via synaptic plasticity, warranting further exploration of thermal treatment for cognitive protection in aging.
39. Clinical Utility and Prognostic Implications of Circulating Cell-Free DNA in Biliary Tract Cancer.
期刊: JCO precision oncology 发表日期: 2025-Sep 链接: PubMed
摘要
An estimated 25% of patients with biliary tract cancer (BTC) do not undergo genotyping, representing a missed opportunity for therapeutic targeting. Cell-free DNA (cfDNA) and matched tumor sample from patients with BTC were analyzed using targeted next-generation sequencing (NGS) assay and compared. We sought to define the molecular profile of cancer-derived cfDNA, frequency of OncoKB level 1/2 alterations, plasma:tumor genotype concordance, the prognostic impact of cfDNA, and clonal evolution after targeted therapy progression. cfDNA-based genotyping was performed on 297 blood samples from 170 patients with BTC. The most frequently altered genes were TP53 (29%), FGFR2 (16%), ARID1A (13%), CDKN2A (11%), and KRAS (11%); 25% of patients had OncoKB level 1/2 alterations and 36.2% of potentially actionable alterations were detected in plasma alone. The cfDNA:tissue concordance accuracy was high (96% IDH1, 98% BRAF, 92% KRAS mutations, 99% ERBB2 amplifications, and 96% FGFR2 fusions). Detectable tumor-derived cfDNA after resection did not predict recurrence. In treatment-naïve metastatic BTC, high variant allele fraction was associated with worse progression-free survival and overall survival. RAS alterations not detected in samples before treatment were identified at progression in 24% of patients who received BRAF-, FGFR-, or HER2-directed therapy, identifying RAS alterations as a convergent mechanism of targeted therapy resistance. Molecular profiling of cfDNA from patients with BTC identified OncoKB level 1/2 gene alterations and putative genomic resistance mechanisms to targeted therapy. Concordance analysis suggests that cfDNA-based NGS is complementary to that of tissue-based sequencing in the identification of potentially actionable alterations.
40. The association of the planetary health diet with type 2 diabetes incidence and greenhouse gas emissions: Findings from the EPIC-Norfolk prospective cohort study.
期刊: PLoS medicine 发表日期: 2025-Sep 链接: PubMed
摘要
The planetary health diet (PHD) has been proposed as a dietary index with potential co-benefits for human and planetary health. Evidence is limited on its association with type 2 diabetes (T2D) incidence and greenhouse gas (GHG) emissions. Our objective was to assess the associations of adherence to the PHD with incident T2D and GHG emissions. We analysed data from 23,722 participants (55% female), with a mean (standard deviation, SD) age of 59.1 (9.3) in the UK-based EPIC-Norfolk prospective cohort study. Dietary intake was assessed across three time points (1993-1997, 1998-2000 and 2004-2011) using a food frequency questionnaire. We assessed adherence to the PHD (theoretical score range 0-140 points) based on the consumption of 13 food groups and two nutrients. Cox proportional hazards regression models, which accounted for time-varying covariates, were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for T2D. Linear regression models were used to analyse the association between the PHD and estimated GHG emissions. During a mean follow-up period of 19.4 (SD 6.8) years, 3,496 cases of incident T2D were recorded over 461,086 person-years. Greater adherence to the PHD was associated with lower T2D incidence; comparing the highest PHD quintile (85.7-117.8 points) to the lowest (33.9-68.4 points), the HR (95% CI) was 0.68 (0.61, 0.76) in the most adjusted model including socio-demographic, behavioural factors, energy intake, adiposity, and prevalent cardiovascular disease or cancer. The estimated population attributable fraction (PAF) for incident T2D due to adherence below the 80th percentile (85.7 points) was 12.3% (95% CI: 9.2%, 15.3%). Those in the highest quintile of the PHD had approximately 18% lower GHG emissions compared to those in the lowest (β5th/1st -18.4% (95% CI: -19.3%, -17.5%)). The main limitation of this research is the possibility of residual confounding due to the observational design of this study. Our findings of a lower incidence of T2D and reduced GHG emissions among those with higher adherence to the PHD support the promotion of this diet for the population-level prevention of T2D and for planetary sustainability.
41. Design approaches for developing quality checklists in healthcare organizations: A scoping review.
期刊: PLOS digital health 发表日期: 2025-Sep 链接: PubMed
摘要
Quality checklists have demonstrated benefits in healthcare and other high-reliability organizations, but there remains a gap in the understanding of design approaches and levels of stakeholder engagement in the development of these quality checklists. This scoping review aims to synthesize the current knowledge base regarding the use of various design approaches for developing quality checklists in healthcare. Secondary objectives are to explore theoretical frameworks, design principles, stakeholder involvement and engagement, and characteristics of the design methods used for developing quality checklists. The review followed the Preferred Reporting Items for Systematic Reviews 2020 checklist. Seven databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, ACM Digital Library, and IEEE Xplore) were searched for studies using a comprehensive search strategy developed in collaboration with a health sciences librarian. Search terms included “checklist” and “user-centered design” and their related terms. The IAP2 Spectrum of Participation Framework was used to categorize studies by level of stakeholder engagement during data extraction. Twenty-nine studies met the inclusion criteria for this review. Twenty-three distinct design methods were identified that were predominantly non-collaborative in nature (e.g., interviews, surveys, and other methods that involved only one researcher and one participant at a given time). Analysis of the levels of stakeholder engagement revealed a gap in studies that empowered their stakeholders in the quality checklist design process. Highly effective, clear, and standardized methodologies are needed for the design of quality checklists. Future work needs to explore how stakeholders can be empowered in the design process, and how different levels of stakeholder engagement might impact implementation outcomes.
42. Sleep in Adults: Insomnia.
期刊: FP essentials 发表日期: 2025-Sep 链接: PubMed
摘要
Sleep insufficiency, insomnia, and related sleep disorders are concerns that affect millions of US adults. The disorders also contribute to significant cognitive, emotional, and physical health challenges. Insomnia affects approximately 30% of the US population. It is characterized by difficulty falling asleep, difficulty staying asleep, and early-morning waking and is linked to daytime distress and impairment. Common sleep disruptors include environmental factors such as noise, light, and air pollution and also personal habits such as excessive screen use before bedtime. Evaluating patients with insomnia in primary care requires integrating sleep health assessments into routine visits and use of insomnia screening tools and sleep diaries for accurate diagnosis. Nonpharmacologic therapies such as sleep hygiene and cognitive behavior therapy for insomnia are the preferred treatments. Pharmacotherapy or combination therapy (with cognitive behavior therapy for insomnia and pharmacotherapy) may be considered when these interventions are ineffective. Family physicians should weigh the risks and benefits of insomnia medication use carefully for all patients but especially for older adults because of potential adverse effects. Managing insomnia effectively in primary care involves a comprehensive approach, prioritizing nonpharmacologic strategies, regular monitoring, and patient-centered care.
43. Mechanisms and Pathogenesis of Diabetic Cognitive Impairment: A Comprehensive Review.
期刊: Aging and disease 发表日期: 2025-Aug-14 链接: PubMed
摘要
Diabetic cognitive impairment (DCI) is a form of cognitive dysfunction that affects individuals with diabetes, marking it as one of the complications linked to this disease. This condition typically presents as deficits in various cognitive abilities, such as memory, learning, language, motor skills, perception, and attention. Studies show that around 13% of diabetic individuals aged 65 to 74 experience cognitive impairment, with this figure rising to 24% for those over 75. As the global incidence of DCI increases, the economic and caregiving challenges for both individuals and society are also growing. The specific mechanisms underlying DCI remain unclear, and the relationships among various pathological processes are still under investigation. The study of DCI mechanisms continues to present numerous unresolved mysteries, such as unclear causal relationships: does metabolic disorder (e.g., hyperglycemia) directly damage neurons, or does it indirectly affect cognition through vascular lesions? Additionally, the mechanisms of individual heterogeneity pose further questions: why do some diabetic patients experience cognitive decline (CD) while others do not? Therefore, understanding the pathological alterations and the fundamental reason behind DCI is essential for improving early prevention and treatment strategies for individuals exhibiting clinical symptoms of this disorder. Furthermore, DCI represents a significant intersection between metabolic and neurodegenerative diseases, which encourages the integration of cognitive assessments into routine diabetes management. This article not only provides a systematic review of existing research but also serves as a bridge connecting basic science with clinical practice, offering theoretical support for the precise prevention and early diagnosis of DCI in patients.
44. Developing an eco-bio-social conceptual framework for dengue virus transmission in Latin America and the Caribbean: An e-Delphi study.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Dengue is a rapidly proliferating, mosquito-borne arboviral disease caused by the dengue virus (DENV), and is endemic in Latin America and the Caribbean (LAC). Evidence from the literature suggests that there are several ecological, biological, and social (eco-bio-social) factors determining dengue endemicity in the region. The primary objective of this study was to develop an eco-bio-social conceptual framework for dengue transmission in LAC. The secondary objective was to establish research, and policy and program agendas for dengue prevention and control in LAC. We conducted a sequential, multi-method study using a 3-round e-Delphi method between May and November 2023. Questionnaires were written in English and translated into Spanish and Portuguese, and data were analyzed quasi-anonymously. Professional panelists evaluated the framework using a 10-item, 7-point Likert scale. Consensus was defined as 70% or more agreement among panelists. Panelists also developed a research agenda and evaluated a policy and program agenda using a 12-item, 7-point Likert scale. Eleven dengue professionals from seven LAC countries participated in this study. The most relevant eco-bio-social factors determining dengue transmission were seasonal weather and urban microclimatic oscillations, vectorial capacity and competence, and urbanization and land use. After three consultation rounds, consensus was achieved on a framework comprising 16 ecological, 11 biological, and 28 social factors. Panelists developed a research agenda based on 3 research themes: ecological and environmental; biological and immunological; and social and cultural research. Panelists developed a policy and program agenda for dengue prevention and control, including 4 categories: government investments, integrated programs, intersectoral approaches, and innovative practices. Majority of panelists (88%) agreed that the agenda can improve dengue prevention and control in LAC. The consensus-based eco-bio-social framework and agendas offer novel opportunities to transform dengue prevention and control strategies in LAC and to address the specific needs and experiences of community members in LAC.
45. A feasibility study: Using mobile phone-based tools to collect community-level Behavioral and Social Drivers (BeSD) of vaccination data in Zambia.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Routine collection of behavioral and social drivers (BeSD) of vaccination data is essential for understanding and addressing vaccine confidence and demand to achieve high vaccination coverage. Traditional house-to-house data collection methods are resource-intensive, prompting the need for alternative, scalable approaches. This study tested the feasibility of using mobile phone surveys to collect community-level BeSD data on COVID-19 vaccination in Zambia. A cross-sectional survey of adults aged 18 and over was conducted in three districts: Lusaka, Kalomo, and Chavuma. Participants were recruited via geotargeted mobile phone messages and responded using push-button inputs. The survey adapted validated BeSD questions from the World Health Organization (WHO) framework and was administered in English and six local languages. Strategies to increase response rates were tested, including offering a small monetary incentive and conducting community outreach via radio jingles. To assess the feasibility of using mobile phone surveys to collect BeSD data, we report on response rates and the demographic distribution of respondents and describe the operational process of applying this methodology. From March to July 2024, a total of 52,983 recruitment messages were sent, yielding an overall response rate of 15.7%. Response rates varied by district, with Chavuma having the highest (68.2%) and Lusaka the lowest (4.2%). Compared to a baseline response rate of 4.7%, offering a monetary incentive increased the response rate to 31.4%, while community outreach increased it to 19.8%. Respondents skewed younger (69.5% aged 18-29 years) and male (65.9%). Mobile phone surveys present a feasible method for collecting real-time BeSD data at the community level in low-resource settings. Incentives and community outreach effectively increase participation, though results may need to be weighted to reflect population demographics.
46. Women-Centric Breast Cancer Care in Low- and Middle-Income Countries: Challenges, Solutions, and a Roadmap for Equity.
期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2025 链接: PubMed
摘要
Breast cancer remains a critical public health challenge in low- and middle-income countries (LMICs), where late-stage diagnoses, limited access to care, and fragmented survivorship support exacerbate disparities in outcomes. This manuscript examines the systemic barriers to delivering women-centric breast cancer care in LMICs, including geographic and socioeconomic inequities, underfunded prevention efforts, and gaps in policy implementation. Building on a proposed roadmap for reform, we advocate for culturally adaptive strategies, community co-creation, and investment in scalable care models. By prioritizing women’s unique needs and fostering multisectoral collaboration, LMICs can transform breast cancer care from survival-focused to empowerment-driven, even amid resource constraints. Improving breast cancer care for women in low and middle-income countries: Guide to acheiving fair health care. Breast cancer is a major health problem in low- and middle-income countries because many women are diagnosed at a late stage, do not have access to good care, and do not get the support they need after treatment. This article looks at the main reasons why it is hard to provide good breast cancer care to women in these countries, including lack of access to healthcare in certain areas, not enough money for prevention efforts, and gaps in policy implementation. We suggest ways to improve care, such as working with local communities to develop solutions that fit their needs and investing in care models that can be expanded. By focusing on women’s unique needs and working together with different groups, low- and middle-income countries can improve breast cancer care and help women feel empowered, even with limited resources.
47. Schwannoma Presenting as Infectious Fluid Collection.
期刊: Journal of primary care & community health 发表日期: 2025 链接: PubMed
摘要
A 33-year-old female presented with finger pain, swelling, and erythema was diagnosed with cellulitis and treated with antibiotics. Persistent symptoms led to further evaluation including a point-of-care ultrasound revealing a cystic structure, concerning for abscess. Incision and drainage yielded a solid mass rather than fluid. Pathological examination revealed a schwannoma, a benign peripheral nerve sheath tumor. This case highlights the rare presentation of a schwannoma mimicking an infectious process and emphasizes the importance of considering peripheral nerve tumors in the differential diagnosis of soft tissue masses, especially when the clinical course is atypical. It also underscores the value of pathological examination in establishing a definitive diagnosis and preventing misdiagnosis, which can have implications for patient management.
48. Exploring the implementation of an evidence-based health promotion intervention for women experiencing intimate partner violence (iHEAL) in diverse contexts: Study Protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This participatory, mixed methods study will explore how iHEAL, a woman-led, nurse-delivered health promotion intervention for women who have experienced intimate partner violence (IPV), can be implemented in real-world, community-based health care settings located in 3 Canadian provinces. Grounded in the Active Implementation Frameworks, the study’s primary aim is to identify the processes, resources and supports necessary to implement and sustain this novel program with fidelity while maintaining its benefits for women. Over 2.5 years, each organization will plan for and deliver the iHEAL program, supported by an iHEAL Consultant. To explore implementation processes and fidelity, successes and challenges, and any value-added of iHEAL to organizations and/or communities, qualitative interviews will be conducted with 3 groups of participants: 1) organizational leaders; 2) implementation/delivery team members (nurses and supervisors); and 3) external stakeholders or agencies supporting iHEAL through referrals or other collaboration. High level notes capturing key issues and decisions at planning meetings will supplement these data. Administrative program data will be collected to assess program reach, participant engagement, and aspects of fidelity. Women participating in iHEAL will also be invited to complete pre/post intervention surveys to assess changes in key outcomes, with a subsample of 60 women to be interviewed about their experiences of iHEAL and suggestions for strengthening the program. Qualitative data will be analyzed using Rapid Team Based Qualitative Analysis and Reflective Thematic Analysis. Quantitative data will be summarized using descriptive statistics; pre-post intervention changes in outcomes collected in women’s surveys will be analyzed using paired t-tests. Ethical approval has been obtained, and all participants will provide informed consent. The findings of this research are expected to yield insights about organizational factors that shape the delivery of iHEAL and support the development of guidance materials for future iHEAL implementation and scale up.
49. Experiences of adult children caring for parents aging in place.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The rapid rise of the older adult population has increased the need for family caregiving. Adult children caring for their aging parents are exposed to a range of stressors, and their experiences shape care outcomes. We aim to describe these experiences using a grounded theory approach and develop a theory based on our findings. The inclusion criteria were adult children of any age who had provided care for at least one year to one or both parents, including parents-in-law, in a home setting. Participants were recruited using snowball sampling from community centers for older adults and churches. Espousing the grounded theory approach that often relies on interviews as a primary data collection method, 22 semi-structured personal interviews were conducted. Thematic analysis was completed using the NVivo software. The challenge-acceptance theory was developed through open coding, axial coding, selective coding, and continuous analysis of the data. The care recipients were aged 65 years and above. The caregivers’ experiences were summarized as a complex and dynamic process with negative and positive aspects, ranging from an increased level of stress and anxiety due to uncertainties of caregiving to the profound meaning and fulfillment experienced during the caregiving process. The results of the coding process consisted of four themes: the unknown, the need for effective communication, aging parents’ behavior, and caregiving. The resulting grounded theory, the challenge-acceptance theory, explains how caregivers transition from caregiving challenges to accepting the challenges. Caregivers struggle with caring for aging parents and experience severe stress, which may affect their health. Healthcare professionals should proactively identify and address these issues before significantly impacting caregivers’ health. Adequate communication with caregivers, provision of helpful resources, and promotion of proactive caregiving strategies can reduce caregiver burden and stress.
50. Quasi-experimental controlled study protocol to reduce sedentary lifestyle in patients with type 2 diabetes.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The prevalence of diabetes has increased worldwide, making it the most prevalent metabolic disorder. Physical inactivity contributes to the progression of this disease and aggravates other comorbidities, such as obesity and cardiovascular disease. Beneficial strategies aimed at promotion and healthy aging, oriented to decrease sedentary behavior, are necessary to obtain desirable metabolic effects and improve the quality of life of people with diabetes. To examine, through a quasi-experimental study, the effect of decreasing sedentary time and increasing motivation to adopt an active lifestyle on different clinical, anthropometric and biochemical parameters in patients diagnosed with type 2 diabetes mellitus. Quasi-experimental controlled study, single-center, parallel, two-branch, with a 12-month follow-up. We plan to recruit up to a total of 169 participants, who will be assigned in a 1:1 ratio to a control group (who will receive e-mails) and an intervention group (who will receive face-to-face group and individual visits and telephone calls). The active intervention has a duration of 6 months and will be carried out by nursing professionals. The primary outcomes are sedentary time measured with the Sedentary Behavior Questionnaire (SBQ) and the use of accelerometers, and the state of motivation to change measured through the Transtheoretical Model of Physical Exercise Change Questionnaire (TMPECQ). Trial registration. ClinicalTrials.gov (NCT06893146).
51. Managing Facial Palsy After Stroke: Results From an Online Survey of Health Professionals.
期刊: International journal of language & communication disorders 发表日期: 2025 链接: PubMed
摘要
Post-stroke facial palsy significantly impacts patients’ communication, eating and overall quality of life. Despite its prevalence, standardised management guidelines are lacking and evidence for assessment and treatment approaches remains limited. To describe UK clinical practice for assessing and treating post-stroke facial palsy and which healthcare professionals play a role. A cross-sectional online survey was conducted using Qualtrics to collect data on participants’ professional lives, assessment and treatment practices. UK healthcare professionals in stroke or facial palsy care were recruited through social media, conferences and professional networks. Ninety-six out of 150 professionals completed the survey, mainly speech and language therapists (40%) and physiotherapists (43%), including 17 others (occupational therapists, nurses, doctors and orthoptists). Speech and language therapists and physiotherapists were the most likely professions involved in the collaborative management of post-stroke facial palsy. The most common assessment was clinical observation (84%). Some assessments were more favoured by certain professions, for example, 71% of nurses and doctors used the National Institutes of Health Stroke Scale; speech and language therapists and physiotherapists used the Sunnybrook Facial Grading System and clinical observational methods more than the ‘Other group’. The most commonly used treatments were orofacial exercises (60%) and facial massage (52%). The study describes current UK practice for managing post-stroke facial palsy and underscores the critical roles of speech and language therapists and physiotherapists. Now that we know what is used and by whom, we should explore the evidence underpinning this practice to guide assessment and treatment and improve outcomes for stroke survivors. What is already known on this subject Post-stroke facial palsy affects 45%-60% of acute stroke patients, significantly impacting physical appearance, communication and quality of life. There are currently no clinical guidelines for managing post-stroke facial palsy, and it is notably absent from national stroke guidelines. Previous international research indicates uncertainty about which professionals should lead facial palsy management after stroke. What this paper adds to existing knowledge This is the first UK-specific survey examining how post-stroke facial palsy is managed across multiple healthcare professions. Speech and language therapists and physiotherapists are identified as the primary providers of post-stroke facial palsy care in the UK. The study reveals significant variations in assessment methods, with most clinicians relying on informal observational approaches rather than standardised tools. Common barriers to implementation include a lack of resources, confidence and clear clinical guidelines. What are the potential or actual clinical implications of this work? The findings highlight a need for standardised assessment tools and evidence-based treatment guidelines for post-stroke facial palsy. Healthcare professionals require specific training in facial palsy assessment and management. Future service development should focus on clarifying professional roles and promoting interdisciplinary collaboration in facial palsy care.